Kounis syndrome: Aspects of incidence and epidemiology

Abstract

To the Editor: Kounis syndrome is a hypersensitivity coronary disorder induced by environmental factors, foods, drugs, conditions and stents. It manifests as coronary spasm, acute myocardial infarction and stent thrombosis, and affects the cerebral, mesenteric and coronary arteries. Allergic, hypersensitivity, anaphylactic and anaphylactoid reactions are associated with this syndrome. Kounis syndrome has been observed in every race, age group (2 - 90 years) and geographical location. It is not a rare disease, but it is infrequently reported in clinical practice because of missed, unrecognised and/or undiagnosed cases. Furthermore, there is apaucity of large prospective trials, determining its prevalence and exact incidence. In a very interesting report published in the SAMJ a 39-year-old man with a previous history of exercise-induced asthma and allergy to cefixime developed type I Kounis syndrome following an allergic reaction to ciprofloxacin. The authors correctly commented on the paucity of data concerning the incidence and prevalence of Kounis syndrome in South Africa and elsewhere.